Quality Improvement Package
Background
In 2006, the Private Sector Partnerships-One project developed a Quality Improvement (QI) package for midwives practicing in the private sector in Uganda. The purpose of this package was to help midwives assess and improve the quality of care that they provide. The materials have been adapted for use by different cadres (physicians and pharmacists) and for different types of settings and services including rural primary health care centers including chronic conditions such as hypertension and diabetes mellitus, STIs and RTIs, MCH and FP, an expanded version for all family planning methods, and three comprehensive modules concerning HIV/AIDS and TB services. A benefit of the self-assessment approach is that it empowers providers to identify problems and consult with their supervisors and colleagues to develop solutions. Providers using this tool and approach are discovering that “quality belongs to everyone” and not just their managers or external reviewers.
Download QI Package hereThe objective of this package is to enable private practitioners to perform a self-assessment of their practice, identify performance gaps and seek ways and support to resolve identified performance gaps.
The components of the Quality Improvement Package are as follows:
- 1) Implementation Guide
- 2) QI Self-Assessment Tool and a review of monthly statistics
- 3) Action Plan
- 4) Supervisor’s Guide
- 5) Training Guide
Application of the QI package in private and public sectors
1. Uganda: Study to determine effectiveness of Q1tool and approach: A research study is underway to determine if the self-assessment tool and action plan improves the quality of services provided by midwives who are members of the Uganda Private Midwives Association with and without support from their supervisors. A baseline study and second round of data collection after the intervention have been completed and data analysis has been completed. The intervention consisted of training 170 midwives and 14 supervisors on how to use the self-assessment tool and problem solving approach. Results of the study about the effectiveness of the tool and whether supervision increases effectiveness by the midwives are expected in early 2008.
2. Jordan: RTI and STI service assessment by general practitioners in private practice: GPs in private practice were trained to provide RTI and STI care according to newly developed guidelines in Jordan. The GPs were then introduced to a self-assessment process and a guided problem solving using an adapted version of the QI package. The GPs are currently participating in a certification process to determine if the care and practice environment meets a certifiable level of quality care.
3. Uganda, Senegal, and India: Family Planning Q1 module for private sector: A comprehensive family planning Q1 assessment tool was developed for six family planning methods and introduced to midwives and pharmacists in private practice in Uganda. Similarly in Senegal, in May 2007, a needs assessment of providers (primarily general practitioners) was conducted in Dakar (Capital city) and St. Louis (the second biggest city) with companies having more than 20,000 employees, in order to support workplace FP services. Data analysis is in process. The plan is to adapt the FP training sessions developed for the public sector for service providers who work for those companies. In India, the comprehensive family planning Q1 self-assessment tool has been adapted for private sector doctors belonging to a network. The Medical Team for the DIMPA network is preparing to conduct a pilot test of the FP QI package with 100 doctors. A monitoring plan has been developed to track results in terms of FP services and quality care provided.
4. Quality improvement package adapted for HIV/AIDS and TB services in the private sector: At the request of USAID/Office of HIV/AIDS three modules were developed: 1) HIV Counseling and Testing, 2) HIV/AIDS Clinical Care and Treatment (ART) and 3) TB Detection and Care. Subsequently these materials were field tested in three countries representing different regions: Dominican Republic, Ethiopia, and India. The purpose of the field test was to determine the feasibility and interest of private practitioners to using a QI self-assessment process and problem solving approach to monitor and improve the quality of HIV/AIDS and TB care provided. The field tests were conducted in August through October 2007. A report of the findings from the three field tests is available and recommendations with next steps about improving quality of HIV/AIDS and TB services in the private sector is being prepared.
5. Armenia: MCH service assessment package for hospitals in public sector: Five quality assurance teams from five marzes (districts) in the public sector in Armenia were introduced to an adapted version of the QI package for hospital care for women and child health services. The oriented QA teams returned to their respective hospitals and introduced a quality improvement process at each of the hospitals.
6. Senegal: Maternal, neonatal, family planning and malaria training and QI package: This package of materials introduced to program managers, trainers/supervisors at regional and district levels, and integrated into existing programs in order to help providers at the health centers and health posts in Senegal assess and improve the quality of service in the public sector. They have been conducting orientation and planning sessions with the regional and district coordinators before the training of providers from health centers and health posts.
Call for Requests and Action
It is a relatively straightforward task to take the existing QI package and training guide and adapt these materials to the needs of a particular provider group with a focus on the services that they provide in the private sector in order to help that group assess and improve the quality of their care. Please contact Dr. Mary Segall at PSP-One for further information, copies of any of the modules mentioned above, or to discuss interest in working with you to improve quality of care in the private sector.
